Eyal Klang1,2, Uri Kopylov2,3, Shomron Ben-Horin2,3, Adi Lahat2,3, Doron Yablecovitch2,3, Noa Rozendorn1,2, Rami Eliakim2,3, Michal Marianne Amitai4,5. 1. Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Ramat Gan, 5265601, Israel. 2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel. 4. Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Ramat Gan, 5265601, Israel. Michal.Amitai@sheba.health.gov.il. 5. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Michal.Amitai@sheba.health.gov.il.
Abstract
OBJECTIVES: Evaluate the ability of MR diffusion-weighted imaging (DWI) to predict patency capsule retention in Crohn's disease (CD). METHODS: Clinical and imaging data were prospectively reviewed for 80 CD patients following patency capsule administration and MR-DWI under institutional review board (IRB) approval with informed consent. Two radiologists separately assessed the presence/absence of restricted diffusion in the distal ileum. Apparent diffusion coefficients (ADC) from three regions of interest on the ileal wall were averaged. The association between restricted diffusion and retention, and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Ability of ADC to predict retention was assessed with receiver operating characteristic (ROC) curve analysis. RESULTS: Restricted diffusion in the distal ileum was associated with capsule retention (p = 0.001, p < 0.0001). Sensitivity, specificity, PPV and NPV of restricted diffusion for capsule retention were 100.0%, 46.2%, 30.0%, 100% and 100.0%, 56.9%, 34.9%, 100%, respectively, for two radiologists. Accuracy of ADC to predict retention was high (area under the curve = 0.851, p < 0.0001). An ADC of 1.47 mm2/s showed 90.0% sensitivity and 50.0% specificity for retention. CONCLUSIONS: Sensitivity and NPV of restricted diffusion for patency capsule retention were 100%, suggesting that DWI may predict gastrointestinal tract capability to pass video camera endoscopy. KEY POINTS: • Capsule endoscopy enables assessment of the gastrointestinal mucosa in Crohn's disease • Prior patency capsule administration is recommended to evaluate gastrointestinal tract patency • MR diffusion-weighted imaging may detect pathological constriction of the ileum • Restricted diffusion in the distal ileum was associated with capsule retention • MR-DWI may predict gastrointestinal tract capability to pass capsule endoscopy.
OBJECTIVES: Evaluate the ability of MR diffusion-weighted imaging (DWI) to predict patency capsule retention in Crohn's disease (CD). METHODS: Clinical and imaging data were prospectively reviewed for 80 CDpatients following patency capsule administration and MR-DWI under institutional review board (IRB) approval with informed consent. Two radiologists separately assessed the presence/absence of restricted diffusion in the distal ileum. Apparent diffusion coefficients (ADC) from three regions of interest on the ileal wall were averaged. The association between restricted diffusion and retention, and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Ability of ADC to predict retention was assessed with receiver operating characteristic (ROC) curve analysis. RESULTS: Restricted diffusion in the distal ileum was associated with capsule retention (p = 0.001, p < 0.0001). Sensitivity, specificity, PPV and NPV of restricted diffusion for capsule retention were 100.0%, 46.2%, 30.0%, 100% and 100.0%, 56.9%, 34.9%, 100%, respectively, for two radiologists. Accuracy of ADC to predict retention was high (area under the curve = 0.851, p < 0.0001). An ADC of 1.47 mm2/s showed 90.0% sensitivity and 50.0% specificity for retention. CONCLUSIONS: Sensitivity and NPV of restricted diffusion for patency capsule retention were 100%, suggesting that DWI may predict gastrointestinal tract capability to pass video camera endoscopy. KEY POINTS: • Capsule endoscopy enables assessment of the gastrointestinal mucosa in Crohn's disease • Prior patency capsule administration is recommended to evaluate gastrointestinal tract patency • MR diffusion-weighted imaging may detect pathological constriction of the ileum • Restricted diffusion in the distal ileum was associated with capsule retention • MR-DWI may predict gastrointestinal tract capability to pass capsule endoscopy.
Entities:
Keywords:
Capsule endoscopy; Constriction, pathologic; Crohn disease; Diffusion-weighted magnetic resonance imaging; Magnetic resonance imaging
Authors: T Van den Bosch; L Valentin; D Van Schoubroeck; J Luts; T Bignardi; G Condous; E Epstein; F P Leone; A C Testa; S Van Huffel; T Bourne; D Timmerman Journal: Ultrasound Obstet Gynecol Date: 2012-09-05 Impact factor: 7.299
Authors: Pietro Valerio Foti; Renato Farina; Maria Coronella; Stefano Palmucci; Noemi Ognibene; Pietro Milone; Cristina Conti Bellocchi; Leonardo Samperi; Gaetano Inserra; Andrea Laghi; Giovanni Carlo Ettorre Journal: Radiol Med Date: 2015-02-04 Impact factor: 3.469
Authors: A Bourreille; A Ignjatovic; L Aabakken; E V Loftus; R Eliakim; M Pennazio; Y Bouhnik; E Seidman; M Keuchel; J G Albert; S Ardizzone; S Bar-Meir; R Bisschops; E J Despott; P F Fortun; R Heuschkel; J Kammermeier; J A Leighton; G J Mantzaris; D Moussata; S Lo; V Paulsen; J Panés; G Radford-Smith; W Reinisch; E Rondonotti; D S Sanders; J M Swoger; H Yamamoto; S Travis; J-F Colombel; A Van Gossum Journal: Endoscopy Date: 2009-07-08 Impact factor: 10.093
Authors: Justin M Ream; Jonathan R Dillman; Jeremy Adler; Shokoufeh Khalatbari; Jonathan B McHugh; Peter J Strouse; Muhammad Dhanani; Benjamin Shpeen; Mahmoud M Al-Hawary Journal: Pediatr Radiol Date: 2013-08-16
Authors: C Hordonneau; A Buisson; J Scanzi; F Goutorbe; B Pereira; C Borderon; D Da Ines; P F Montoriol; J M Garcier; L Boyer; G Bommelaer; V Petitcolin Journal: Am J Gastroenterol Date: 2013-11-19 Impact factor: 10.864
Authors: S A Taylor; F Avni; C G Cronin; C Hoeffel; S H Kim; A Laghi; M Napolitano; P Petit; J Rimola; D J Tolan; M R Torkzad; M Zappa; G Bhatnagar; C A J Puylaert; J Stoker Journal: Eur Radiol Date: 2016-10-18 Impact factor: 5.315
Authors: Bruno Cunha Fialho Cantarelli; Rafael Santiago de Oliveira; Aldo Maurici Araújo Alves; Bruno Jucá Ribeiro; Fernanda Velloni; Giuseppe D'Ippolito Journal: Radiol Bras Date: 2020 Jan-Feb